Saturday, December 15, 2007
Pennsylvania's Ed Rendell Playing Games With Mcare Abatement
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The Governor of my state, Ed Rendell, has decided he wants to spend any surplus from the catastrophic malpractice insurance fund (which pays awards and settlements over $500,000) on providing insurance for uninsured adults in Pennsylvania. He wants this so much that that he's threatened not to renew the Mcare program unless he gets what he wants. Thought he State Senate has voted to extend the abatement, the House adjourned before voting.
Here's an interesting quote from Rendell:
"We're not going to go through the pain initially of having the doctors send in their checks, and then having to return them if we continue the (subsidy)," Rendell said after speaking at a nurses' conference in Hershey."
What about the pain of the physicians who will have to figure out how to get the money to pay the full amount in January rather than April? Does the Governor think it's harder for the State to issue a refund than it is for doctors to get their hands on that kinds of money?
There should be no linkage between renewal of Mcare abatement and funding of the Cover All Pennsylvanians insurance program. Mcare funds should be used to cover the program's unfunded liability and make it easier to privatize later. The Governor's Cover All Pennsylvanians should get funding in a way that does not impact Mcare's ability to retire unfunded liability and he should stop playing political games to fund it otherwise.
Sunday, June 10, 2007
Pennsylvania Doctor Trap Number Two Proposed
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Pennsylvania has chosen an interesting strategy to keep doctors from leaving the state. Rather than fix the current jackpot medical malpractice system they've decided to try to trap doctors that are already here.
The first example of this was something called the MCARE abatement program. The Medical Care Availability and Reduction of Error (MCARE) Act replaced an existing catastrophic coverage fund with a new fund to cover awards which exceeded the primary coverage provided by professional liability policies. Each physician must pay into the fund a percentage of their primary premium to sustain the fund.
The MCARE abatement program (or Health Care Provider Retention Program) provides some financial relief from paying premiums to the fund. How much relief a physician gets depends on the practitioners specialty. And here we come to trap number one. If you accept the abatement, you agree to practice in the state for the year in which you receive the abatement AND the next year. If you leave early, you have to pay back the full amount of the abatement.
The legislature is now working on trap number two--a physician loan forgiveness program. For a period of ten years, for every year a physician practices in Pennsylvania after completing training the state will pay off ten percent of their student loan debt. If they leave early (say, after five years), they have to pay the state back ALL of the money the state paid toward their loans.
Friday, June 8, 2007
Pennsylvania's Lawmakers Could Learn From Texas
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Texas enacted tort reform in 2003, capping damage awards at $250,000. In an article titled "Insurance companies, doctors flock to Texas" David Hendricks passes along some facts I hope Pennsylvania legislators take to heart:
- Malpractice insurance rates have fallen an average of 21%
- The number of companies offering malpractice insurance in the state has risen from four to thirty
- Malpractice lawsuits have fallen 50%
- Doctors are coming to Texas, as evidenced by 2,250 pending applications for medical licensure
[Kevin, MD]
Monday, May 7, 2007
Another Obstetrics Ward in Philadelphia Plans To Close
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The Philadelphia Inquirer published an article over the weekend titled Demise of maternity wards is inducing . . . The Baby Scramble
"Blaming financial losses and a deluge of patients who previously might have gone to other, now-defunct maternity wards, Jeanes Hospital is closing its obstetrics unit May 31. Chestnut Hill Hospital is reviewing its obstetrics program as well and has not ruled out closure."
Lots of other good data in that article, too, such as the time-line for closure of other OB units in the greater Philadelphia area:
- Medical College of Pennsylvania (1997)
- Nazareth (1998)
- Germantown (1999)
- City Avenue (1999)
- Roxborough (1999)
- Warminster (2000)
- Elkins Park (2001)
- Episcopal (2001)
- Mercy Philadelphia (2002)
- Methodist (2002)
- Mercy Fitzgerald (2003)
- Parkview (2003)
- Frankford-Torresdale (2006)
- Jeanes (2007)
Pennsylvania Physician Supply Back In The News
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A recent Health Affairs article titled Changes In Physician Supply And Scope of Practice During A Malpractice Crisis: Evidence From Pennsylvania has gotten a great deal of national media attention. It's conclusion was as follows:
"...This study found that the proportions of physicians restricting their scope of practice and exiting practice in Pennsylvania were similar during and before the malpractice crisis for most high-risk specialties. The overall supply of high-risk specialists did not decrease during the crisis except in obstetrics-gynecology."
I've been thinking about this article for a while now. I've written to the lead author asking about the inclusion of medical residents-in-training in their statistics but have yet to hear back. Including residents may hide important trends. For example, new residency programs may have opened during the study period. Trading doctors who are fresh out of internship for experienced specialists is not a good deal, but the numbers as used wouldn't show this.
Another question I have is 'compared to what?' What has happened in other states during this time? According to the Dauphin County Medical Society, among the twenty most populous states, only Pennsylvania and California saw their physician supply drop during the study period. All others saw an increase of 10-20% in physician supply.
Friday, April 27, 2007
Pennsylvania Malpractice Numbers Ignored?
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I composed a polite letter to the editor of our local paper, the Patriot-News. It went something like this (exactly like this, actually):
"Title: Is Pennsylvania's Malpractice Crisis Solved? Maybe for trial lawyers.
Dear Editor,
Data just published by the non-profit, non-partisan Kaiser Family Foundation at http://www.statehealthfacts.org/ provides facts to consider in our discussion of health care reform in Pennsylvania.
Based on data from the National Practitioner Databank, Pennsylvania ranks third in the nation in the number of paid malpractice claims per thousand physicians (http://tinyurl.com/22mppw). Pennsylvania ranks second only to New York in total payments for claims made during 2006--over $300,000,000 (http://tinyurl.com/26hh9p).
Please consider passing these facts on to your readers so that they may form their own conclusions about the state of Pennsylvania's malpractice system. I submit that being ranked second and third in the nation in two objective measures of malpractice payouts does not support those who contend that our malpractice crisis is 'over.'"
Was it published? Nope. Oh, well.
It WAS published on Sunday, April 29th, 2007,
Wednesday, April 18, 2007
PA Ranks Second in Total Dollars Paid in Malpractice Claims
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At the same website mentioned in the preceding post one can find information on total dollars paid in malpractice cases in 2006. Pennsylvania ranked second with $308,781,000 paid (second only to New York). See for yourself.
Vermont looks pretty good to me right now...
PA Ranks Third in Paid Malpractice Claims
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The Kaiser Family Foundation maintains StateHealthFacts.org, a site "designed to provide free, up-to-date, and easy-to-use health data on all 50 states". The site just published Number of Paid Medical Malpractice Claims, 2006. Pennsylvania ranks third among all states in number of malpractice claims paid per thousand physicians. See for yourself.
Tuesday, March 27, 2007
New Study on Malpractice Costs
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Pacific Research Institute:
JACKPOT JUSTICE: The True Cost of America's Tort System
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